Us Congress 2025-2026 Regular Session

Us Congress House Bill HB2554

Introduced
4/1/25  

Caption

Lower Drug Costs for Families Act This bill applies certain Medicare prescription drug rebate requirements to prescription drugs that are available under private health insurance. Current law requires drug manufacturers to issue rebates to the Centers for Medicare & Medicaid Services for brand-name drugs without generic equivalents under Medicare that (1) cost $100 or more per year per individual, and (2) for which prices increase faster than inflation. Manufacturers that fail to comply are subject to civil penalties. The bill applies these requirements to prescription drugs that are available in the commercial market under private health insurance. It also indexes rebate calculations to drug prices in 2016 (as opposed to 2021).

Impact

If enacted, HB2554 would modify existing pricing structures by altering the baseline year for rebate calculations from October 1, 2021, to October 1, 2016. This change means that the basis for calculating these rebates would reflect older pricing, likely resulting in more favorable outcomes (i.e., lower costs) for consumers. The amendments are expected to be applicable starting October 1, 2025, with provisions designed to yield more substantial savings on medications in the long run. Consequently, this bill is anticipated to provide financial relief for both public health programs and families purchasing medications out-of-pocket.

Summary

House Bill 2554, also known as the Lower Drug Costs for Families Act, aims to amend Title XVIII of the Social Security Act by applying prescription drug inflation rebates to drugs provided in the commercial market. This proposal is intended to alleviate the burden of high drug costs on American families, offering a framework that could potentially lead to significant reductions in the prices residents pay for prescription medications. By enhancing rebate mechanisms, the bill seeks to ensure that inflationary increases in drug prices are countered effectively, thereby maintaining fair access to affordable healthcare for the public.

Contention

There may be notable points of contention regarding the bill, primarily concerning the implications it holds for pharmaceutical manufacturers. Critics may argue that altering rebate structures could introduce challenges for drug supply stability and innovation within the pharmaceutical industry. Some stakeholders in the industry might view this move as a potential encroachment on pricing freedom, potentially arguing that it could stifle investment in research and development for new medications. Proponents, however, contend that the primary focus should be on making healthcare more attainable, particularly in light of rising drug costs.

Congress_id

119-HR-2554

Policy_area

Health

Introduced_date

2025-04-01

Companion Bills

US SB1186

Related bill Lower Drug Costs for Families Act This bill applies certain Medicare prescription drug rebate requirements to prescription drugs that are available under private health insurance. Current law requires drug manufacturers to issue rebates to the Centers for Medicare & Medicaid Services for brand-name drugs without generic equivalents under Medicare that (1) cost $100 or more per year per individual, and (2) for which prices increase faster than inflation. Manufacturers that fail to comply are subject to civil penalties. The bill applies these requirements to prescription drugs that are available in the commercial market under private health insurance. It also indexes rebate calculations to drug prices in 2016 (as opposed to 2021).

Previously Filed As

US HB133

Mandating Exclusive Review of Individual Treatments (MERIT) Act This bill specifies that coverage determinations for drugs and biologics under Medicare must be made with respect to each drug or biologic, rather than with respect to a class of drugs or biologics.

US HB10409

To address the high costs of health care services, prescription drugs, and health insurance coverage in the United States, and for other purposes.

US HB167

Patient Access to Urgent-Use Pharmacy Compounding Act of 2023 This bill relaxes certain requirements for compounding drugs that are facing shortages. Drug compounding is the process of mixing or otherwise altering drugs to create a medication. Currently, the Food and Drug Administration (FDA) allows for drug compounding subject to certain requirements. Generally, a licensed pharmacist or physician not registered with the FDA may only compound drugs in limited quantities for prescriptions for a specific individual patient. On the other hand, an FDA-registered outsourcing facility may compound drugs in bulk for use in medical facilities but is subject to additional requirements. This bill allows a compounder not registered with the FDA to compound drugs in limited quantities for an urgent medical need not involving a specific patient if, among other requirements (1) the prescriber certifies that the prescriber is unable, despite reasonable attempts, to obtain certain related drugs with the same active ingredient and route of administration; (2) the compounded drug meets certain labeling requirements, including an indication that the compounded drug is provided only for urgent administration to a patient; and (3) the compounder requests and maintains certain records about patients receiving the compounded drug. Furthermore, a restriction against an unregistered compounder regularly compounding (or compounding inordinate amounts of) what is essentially a copy of a commercially available drug shall not apply if the drug is on a shortage list maintained by the FDA or the American Society of Hospital Pharmacists.

US SB1450

Cutting Medicare Prescription Drug Prices in Half Act

US HB4881

To amend title XVIII of the Social Security Act to limit cost sharing for drugs under the Medicare program.

US HB4028

Territories Medicare Prescription Drug Assistance Equality Act of 2023

US HB10305

To amend title XVIII of the Social Security Act to exempt certain drugs from the part D manufacturer discount program under the Medicare program.

US HB4895

Lowering Drug Costs for American Families Act

US HB456

Fairness in Orphan Drug Exclusivity Act This bill limits which orphan drugs may be granted a market exclusivity period by the Food and Drug Administration (FDA). (Generally, an orphan drug is one that is not economically viable because of the rarity of the disease that it treats; the sponsor of an FDA-designated orphan drug may be granted various incentives, such as a seven-year period in which the FDA may not grant market approval to a different sponsor for the same drug to treat the same disease.) Under this bill, if a drug is designated as an orphan drug on the basis that there is no reasonable expectation that the sponsor will recover the costs of developing and distributing the drug from U.S. sales, the drug shall be granted the seven-year exclusivity period only if the sponsor demonstrates that there is no reasonable expectation that it will recover such costs within its first 12 years of U.S. sales of the drug. When deciding whether an orphan drug meets this requirement, the FDA shall consider the sales of all drugs from the sponsor that are covered by the same orphan drug designation.

US HB3093

Affordable Pricing for Taxpayer-Funded Prescription Drugs Act of 2023

Similar Bills

CA ACA1

Public finance.

CA ACA19

State finance: budget: unemployment insurance debt repayment.

US HB1832

Special Immigrant Visas for Afghan Fulbright Scholars Act of 2023

IA HF668

A bill for an act relating to property taxation for commercial child care centers and facilities and including effective date, applicability, and retroactive applicability provisions.(Formerly HSB 224.)

IA HSB224

A bill for an act relating to property taxation for commercial child care centers and facilities and including effective date, applicability, and retroactive applicability provisions.(See HF 668.)

IA HF991

A bill for an act placing assessment limitations for property tax purposes on commercial child care facilities, and including effective date, applicability, and retroactive applicability provisions.(Formerly HSB 316.)

IA HSB316

A bill for an act placing assessment limitations for property tax purposes on commercial child care facilities, and including effective date, applicability, and retroactive applicability provisions.(See HF 991.)

IA SSB3181

A bill for an act placing assessment limitations for property tax purposes on commercial child care facilities, and including effective date, applicability, and retroactive applicability provisions.